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1902931421
JONATHAN R POYOUROW
FORT CAMPBELL, KY
NPI
1902931421
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: GA ld002888)
Enumeration Date
2007-02-23
Last Update Date
2007-07-08
Business Address
-- JONATHAN R POYOUROW r.d.
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number: 270-798-8372
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Mailing Address
-- JONATHAN R POYOUROW r.d.
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number: 270-798-8372
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